DH'S Moods - any suggestions for what MENTAL ILLNESS he might have?

[IsThisJustDepression]

DH seems to be more than one person at the moment: He swings between:-

UTTER DESPAIR where everything is his fault he wants to change, he'll do anything

ANGER where everything is my fault and I am controlling/manipulating/lying to him

or

APATHY where he seems completely detached from everything.

He can often swing from one mood to the next in moments - despair and anger are his main feelings.

He has a diagnosis of severe depression and is on ADs (Citalopram) and has been seeing a general counsellor since last Summer. He hasn't seen anyone else to evaluate him. His mood at counselling is always MISERY although he is often in the grips of ANGER afterwards.

I made a list of some of his symptoms (they may seem a bit jumbled):-

Memory loss ? can?t remember what he believed or happened last week
Self-harm - when angry often punches or headbutts walls, and has also planned to cut himself severely (although I got him to GP)
Mood swings
Delusions (?) - rewrites actions of self and others to make self appear ?good? and others appear to be the problem
Blaming me for his feelings and inability to 'get better'
Unable to value things/people previously highly valued
Self critical as well as self-aggrandising depending on whether in the grip of misery or anger.
Rationally accepts logical conclusions to behaviour and then dismisses them and states that he never accepted the conclusions (although at the time was insistent that he agreed)
Belief that all his problems are my fault; that I am controlling and holding him back from getting better.
Mis-remembered history as having offered support but not received any.
Inflated sense of own input into the relationship
Apathy towards marriage and affect of his actions on children
Passive Aggressive (suggested by counsellor) - says he hates confrontation but when angry seeks confrontation.

I'm sure I'll think of more. I want to take him to the GP again - this seems like more than just depression (although I am happy to be corrected).

He also holds down a steady job and this has not been affected by his problems.

Please help TIA

I can only answer as someone who suffers from depression and would say that he sounds as if the ADs he is taking aren't helping him enough. He needs to go to the GP, and say that he is not getting better. I am assuming he has been taking the citalopram since last summer as well - if they were going to help they would have done within a month, in my experience. What dosage is he taking?

The symptoms you have mentioned to me sound like ones I have had at various times during depression. I am sure that there have been times for DH when I have been really not nice to have around .

I have also found that Cogntive Behaviour Therapy (CBT) has helped me, epseically in terms of over generalising things and only seeing the negative side.

i would say he needs to see a psychiatrist who can re evaluate , change his meds and offer different treatment. if he has been having counselling since last summer, but still in the grip of things, then something needs to change

Thanks for replies. I've been trying to get him to go to a GP to review his meds (40mg) since before Christmas. He's not even seen his GP for months

Getting him to go is going to be a struggle, but if he won't then I will have to go for him.

I really think he needs a proper psych evaluation, but he likes his counsellor and says she's helping (although his behaviour is getting worse and worse). I also think he lies to her so she'll say he's getting better and he doesn't have to listen to me.

sounds like a type of severe depressive illness but he may have co-morbid problems to do with his personality. is he dependent/avoidant/obsessive? What is he like interpersonally re relationships? Does he swing between idealization and devaluation in close relationships?

What's his sense of self like? Is it fragile or robust? What's his percieved identity? Sometimes people with these problems cab feel like they don't actually exist, a kind of emptiness.

What function does the self-harm serve? IS he punishing himself? Ridding himself of unbearable emotional pain? Or making himself feel like a real person when he feels the pain/sees the blood? Does it cause a sense of elation?

Doesn't sound like the counsellor is helping tbh! It sounds like she's become totally tied into his schema as a kind of dependency thing.

Sound like he needs some work around emotional management rather than person centred, something a bit more structured.

let me know what you think

Minx:-

dependent - definitely, also been told by counsellor that we are stuck in adult/child roles (me adult)

Currently swinging between idealization and devaluation, but originally always idealised everything.

Fragile sense of self - built up mostly of "what I think of him" (although this is based on what he thinks I think, rather than my actual words or actions)

Self harm mostly to punish himself and get rid of the emotional pain, but lately has been lashing out when angry and punching things etc (cannot cope with feelings of anger at all) don't think it causes elation.

Does that answer (or just more jumbledness)?

Have you done any reserach into borderline personality disorder? I'll try to suggest something helpful for you, have a think...

You can google it if you want but there's a lot of crap out there, v judgmental. Maybe try the DSM IV criteria that gives you a lsi of symptoms. A helpful skills book is "overcoming intense emtions and self-destructive habits" by Lorraine Bell a clinical psychologist. Marsha Linehan has also written some excellent literature on the subject.

I'm an RMN and trainee CBT therapist doing my dissertation on deliberate self-harm and young people at risk of developing BPD.

What's his personal history/upbringing like? can you think of anything that mey have contributed to the development of these difficulties?

Thanks Minx - will check it out.

Upbringing - very strong matriarchal mother and father with OCD/social issues. Happy marriage between parents but not very affectionate. Heavy cannabis user in his teens, but not since 20yrs-ish. Never any major traumas until we lost a baby and I don't think he ever really coped with the grief of it all. He was also away at the time so blamed himself for not being there (this was 6 years ago now).

He was the eternal optimist but this gradually faded in the last few years and he is now a complete pessimist.

Definitely seems to be actively obstructing his getting better.

well maybe not BPD then. sounds like maybe an abnormal/delayed grief reaction, the delusional bit may be linked to the cannabis unfortunately combined with the effects of grief.

Hope you find the answers you're looking for, sounds like he could do with a full re-assessment and formulation of his difficulties by a pschologist or a decent psychiatrist, someone who doesn't just pop out pills.

Have looked through the "mind" definition and although he has a couple of the symptoms I don't think it fits.

The anger is exactly right though.

Something's really not right with him and is getting worse. He has no control over his emotions at all and his angry episodes are almost always at a "perceived injustice" that doesn't actually exist - he just wants something that he can't have. He will be livid and scary for hours and then suddenly remorseful and sorry.

Advice on anger management would be useful too.